INDEX

cover test with, 161

danger of missing by use of single

letters, 32, 36

9-point tests, 212–214

family history of, 22

microtropia and, 200

stereoacuity and, 201, 203

abnormal retinal correspondence

suppression assessment, 197

VA readings with, 41

AC/A (accommodative

ametropia, 89, 93, 146

as cause of anxiety, 17

checking ocular history for, 83–84

accommodation amplitude: push-up/

symptoms of, 29, 83, 221

amplitude of accommodation push-

accommodation assessments for

up/push-down test, 191–194

ampullae, of vortex veins, 229, 306

(Fig. 6.73)

accommodation balance, 119–125

see also website

accommodative

Amsler charts, 43, 44–45

anaesthetics, 249, 252, 258, 273, 279,

281

instillation procedure, 282

accommodative facility

anatomical interpupillary distance

measurement, 93–95

accommodative fluctuations, 102,

aniseikonia, 145, 197, 203

anisocoria, 130, 285

acquired colour vision testing, 69–70

anisometropia, 89, 166, 197, 200

prescribing for, 145

anterior chamber angle

assessment before instillation of

drugs, 280

gonioscopy examination with

corneal-type lenses, 269–272

adaptation problems with new

gonioscopy examination with

Goldmann 3-mirror lens,

‘against’ movement (retinoscopy),

264–269, 264 (Fig. 6.53)

shadow test angle estimation,

262–263

alcohol, 249, 319, 325

van Herick angle assessment,

aligning prism, 184

260–262, 262 (Fig. 6.51), 280 see

also website

anterior segment slit-lamp

Alzheimer’s disease, 216

biomicroscopy examination,

amaurosis fugax, 319, 320, 327

236–241

amblyopia

specialised illumination

techniques for, 241–248

antidepressants, 216, 249, 281

binocular Esterman test, 66–67

von Graefe phoria technique,

information for ocular health

binocular indirect ophthalmoscopy

176–178

assessment, 221–222

(BIO) in dilated fundus

Worth 4-dot test, 197–199

information for visual function

examination, 8

BIO see binocular indirect

assessment, 29

headband, 301–308

ophthalmoscopy

interpretation, 27

binocular subjective refraction,

biomicroscopy

non-disclosure of symptoms, 13

125–128

indirect fundus biomicroscopy,

procedure for taking, 22–25

binocular vision assessment

286–294

recording, 26–27

4 base-out test, 199–201

slit-lamp examination of anterior

safety check information for drug

9-point tests, 212–214

segment and ocular adnexa,

installation, 279–281

accommodative facility

236–241

use in counselling the patient, 147

measurement, 195–197

specialised spit lamp illumination

use in problem-oriented

amplitude of accommodation

techniques, 241–248

examination, 12

push-up/push-down test,

birth history, 152–153

see also birth history; family

191–194

Bland–Altman plot, 3

medical history; family ocular

case history information for,

bleaching, 46–47

history (FOH); medical

151–153

blepharitis, 221

history; ocular history (OH)

comitant heterotropia

blink dynamics, 251, 256

cataracts

classification, 155–157

blood pressure measurement,

anticataract drug trials, 48

cover test, 157–167

319–320, 322–326

astigmatic change caused by, 113,

fusional reserves measurement,

blurred vision

117

180–184

non-disclosure of, 13

binocular refraction difficulties

heterophoria classification,

questioning concerning, 22, 83

with, 125

153–155

as a symptom, 29, 83, 129, 152, 221,

contrast sensitivity testing in, 48–50

Hirschberg, Krimsky and Bruckner

249

cortical, 84, 113, 117, 153, 233–234,

tests, 167–169

tolerance of, 144

234 (Fig 6.27), 244 (Fig. 6.41)

incomitant heterotropia

Brightness Acuity Tester (BAT) glare

see also website

classification, 155, 206–207

test, 47

detection by retinoscopy, 98

information from other

broad H test see motility test

differentiation by illumination of

assessments for, 153

Bruckner test, 168–169

optical section of the lens,

information relevant for

see also website

242–243

assessment of ocular health,

glare testing in, 47–48

222

calculations for tentative reading

as indication for further

jump convergence tests, 190–191

addition, 132–137

investigations, 84

Maddox rod test, 171–174, 212–214

capsular remnants, posterior lens,

nuclear, 84, 233, 233(Fig. 6.26), 242,

Maddox wing measurement,

234 (Fig. 6.28)

298 see also website

174–176

see also website

posterior subcapsular, 24, 41, 153,

Mallett fixation disparity unit,

carotid artery assessment, 320,

222, 233, 234 (Fig. 6.28), 243 see

184–187

326–329

also website

modified gradient AC/A ratio test,

carotid artery stenosis, 319, 320, 326

recording, 248

178–180

carotid bruit, 327, 328–329

retro-illumination viewing, 244,

modified Thorington test, 169–171

case history

244 (Fig. 6.41)

motility test (broad H test),

baseline history taken by clinical

visual function assessment behind,

207–212

assistants, 6

41–43

near point of convergence test,

common abbreviations, 25

CCLRU (Centre for Contact Lens

188–190

(Tbl. 2.3)

Research Unit) scale, 248

Nott and Mem Dynamic

common procedure errors, 27

cells, floating in anterior chamber,

retinoscopy, 194–195

information areas provided by,

247

Park’s 3-step test, 214–215

21–22

central visual field analysis, 12, 60–65

prism flippers test, 187–188

information for binocular vision

10-2 analysis, 43

pursuits test, 211–212

assessment, 151–153

with Amsler charts, 44–45

saccadic movement assessment,

information for considering

fast analysis, 53–57

215–217

physical examination

HFA 30-2 and 24-2 programmes,

Titmus Fly test, 204–206, 205 (Fig.

procedures, 319

60–63

5.15)

information for determination of

information relevant for assessment

TNO stereo test, 201–204

the refractive correction, 83–84

of ocular health, 222

single field analysis, 43, 55, 56 (Fig.

clock dial test for astigmatism, 117,

written consent for release of

3.6), 63–64

119

medical information, 313

central visual field screening

coefficients of repeatability (COR),

contact lenses

frequency doubling perimetry

4–5

anxiety over inability to continue

(FDP), 50–53

collagen plug occlusion, 253–256

with, 17

multiple stimulus suprathreshold

see also website

dry eye with, 249

strategy, 57–59

colour vision defect implications, 75,

keratoscopy and, 85, 86

single point suprathreshold

76 (Box. 3.1)

monitoring complications, 248

screening, 59–60

colour vision tests

contrast sensitivity (CS) testing, 12,

cerebellar disease, 216

acquired colour vision testing,

48–50, 212, 222

cerebral palsy, 193

69–70

information relevant for assessment

chalazion, 89, 113, 117

City University test, 72–74

of ocular health, 222

children’s eye care

congenital colour vision testing, 75

convergence excess, esophoria, 129,

20 base-out test, 183–184

Farnsworth–Munsell D-15 test,

144, 155, 179

accommodative fluctuations and,

69–72

convergence insufficiency,

102

information relevant for

exophoria, 155

advantage of trial frame for, 97

assessment of ocular health,

convergence tests

anterior chamber angle depth

222

jump convergence, 190–191

estimation, 261, 263

Ishihara test, 70, 74–78, 74

near point of convergence (NPC)

avoidance of autorefraction in,

(Fig. 3.13)

test, 188–190

103–104

SPP-2, 78–79

convex iris technique, gonioscopy,

Lang stereotest, 206

use of clinical assistants for

267

Mohindra near retinoscopy, 131–132

screening, 5

Copeland’s straddling technique,

need for objective measurement of

comitant heterotropia classification,

retinoscopy, 101

refractive error, 97–98, 103

155–157

corneal appearance

objective measurement of

communication skills, 14–17

in normal elderly eye, 231–232

heterotropia, 167

giving bad news, 20–21

in normal eye in young adults, 223

Titmus Fly stereopsis test, 204–206

listening skills, 18

corneal arcus, 231, 231 (Fig. 6.18)

touching responses to Worth 4-dot

for putting the patient at ease, 18

see also website

test, 199

questioning skills see questioning

corneal compression technique,

use of relevant binocular vision

skills

gonioscopy, 272

information, 222

compensated heterophoria, 155

corneal erosion, 221

visual acuity testing alternatives

concordance values, 5

corneal optical section illumination

for children, 32, 36

concretions, 223, 231 (Fig. 6.21), 232

technique, 242

chlamydial conjunctivitis, 319, 322

see also website

corneal reflection pupillometers,

choroidal naevus, 228, 293 (Fig. 6.69)

confirmation lenses, 141, 141 (Fig.

93, 95

CHRPE (congenital hypertrophy of

4.17)

corneal topography, 85–86, 89

the retinal pigment

confrontation field testing, 68–69

see also keratometry

epithelium), 228, 228

congenital colour vision testing, 75

coronary artery disease, 320, 327

(Fig. 6.15), 235

Ishihara test, 74–78, 74 (Fig. 3.13)

Corrected Pattern Standard

see also website

congenital hypertrophy of the retinal

Deviation (CPSD), 7, 64

ciliary arteries, long posterior, 229,

pigment epithelium (CHRPE)

correlation coefficients, 3, 5

306 (Fig. 6.73)

in normal elderly eye, 235

cortical cataract, 84, 113, 117, 153,

see also website

in normal eye in young adults,

233–234, 234 (Fig. 6.27), 244

ciliary body (CB), 269

228, 228 (Fig. 6.15)

(Fig. 6.41)

ciliary nerves, long posterior, 229,

see also website

see also website

306 (Fig. 6.73)

congenital vascular tortuosity,

corticosteroids, 24, 222, 233

see also website

229, 229 (Fig. 6.16)

cost of spectacles, 17, 148

cilio-retinal artery, 226 (Fig. 6.9),

see also website

counselling the patient, 147–148

228–229

conical beam illumination technique,

explaining diagnoses, prognoses

City University colour vision test,

slit-lamp biomicroscopy, 247

and management plans, 19,

72–74

conjunctival appearance

147–148, 311

clinical assistants

in normal elderly eye, 232

giving bad news, 20–21

use in autorefraction, 103

in normal eye in young adults, 223

cover test, 157–167

use in PD measurement, 95

consent

9-point test, 212–214

use in routine screening, 5–6

informed see informed consent

alternating, 164

cover test (contd)

digital imaging, 310–311

detection of comitant heterotropia,

dilation and irrigation (D&I), 256,

155

258–259, 260

subjective, 164

dim reflex, retinoscopy, 101–102

unilateral, 160–164

diplopia, 152, 153, 177, 180–182, 221

validity assessment, 2

near point of convergence and,

see also examples on website

188, 189, 190

CPSD (Corrected Pattern Standard

direct illumination techniques, slit-

Deviation), 7, 64

lamp biomicroscopy, 242–243

cranial nerve palsy, 153

direct ophthalmoscopy, 294–299

crystalline lens appearance

in dilated fundus examination, 8

in normal elderly eye, 232–234 see

disability glare, 47, 48, 222

also cataracts

discriminative ability of tests, 3–4

in normal eye in young adults,

distance visual acuity testing

224, 224 (Fig. 6.5) see also

using LogMAR charts, 29–34

website

as part of penlight glare test, 47–48

CS (contrast sensitivity) testing, 12,

using Snellen charts, 34–38

48–50, 212, 222

divergence excess, exophoria, 155

cyclodeviation, 105, 125

divergence insufficiency, esophoria,

cyclopentolate, 129, 130

155

cyclophoria, 105, 125, 154

Down’s syndrome, 193, 280

cycloplegia, 14, 103, 129–130, 144,

drugs

280, 281

antidepressant, 216, 249, 281

cycloplegic refraction, 12, 102,

case history information on, 21,

128–132

24–25

cyclotropias, 157

as cause of dry eye, 249

cylinder changes, prescribing, 145

causing maculopathy, 43

cystoid degeneration, 229

cycloplegic, 129, 279

cysts, sebaceous, 230, 231 (Fig. 6.18)

instillation of diagnostic drugs,

see also website

279–283

mydriatic, 279, 280, 281, 283

database examination, 11

staining agents, 249–251

decompensated heterophoria, 155, 221

drusen

dermatochalasis, 230, 230 (Fig. 6.17)

at the disc in normal young eye,

see also website

227 see also website

deuteranopes, 75

at the macula in normal elderly

DFE (dilated fundus examination), 8

eye, 235, 235–236 (Figs 6.31-3)

diabetes, 24, 222

see also website

as cause of acquired colour

dry eyes

defects, 69

caused by medications, 24, 249

as cause of contrast sensitivity

diagnostic lacrimal occlusion,

loss, 48

253–256

as cause of refractive error change,

dry eye assessment, 249–251

84

meibomian gland evaluation, 247

family history of, 22, 319

phenol red thread and Schirmer

relevance when considering

tests, 251–253

physical examination

duochrome (bichrome) test, 111–112,

procedures, 319, 320, 327

114 (Fig. 4.11), 126

symptoms of, 153

dynamic retinoscopy, Nott and

diabetic retinopathy, 24, 69, 264, 320,

MEM, 194–195

327

diagnosis communication

ectropion, 22, 230, 251

to patients, 19, 147, 311

Efron scale, 248

in referral letters and reports, 313

empathy, 14, 17

diagnostic drug instillation, 279–283

endothelium, corneal, 244–246

dichromats, 75

see also website

papilloma, 230, 232 (Fig. 6.24) see

frequency doubling perimetry (FDP),

also website

50–53

ptosis, 22, 153, 230

Frisby test, 203–204

sebaceous cysts, 230, 231 (Fig. 6.18)

Frisby test, stereopsis, 201

see also website

fundus assessment

xanthelasma, 231, 231 (Fig. 6.19)

with biomicroscopy, 12, 41–42,

see also website

286–294 see also website

with digital imaging, 310–311

FACT chart, contrast sensitivity, 49

by direct ophthalmoscopy, 294–299

falling risk

by Goldmann 3-mirror lens, 308–310

eye care for those at risk, 25

by headband binocular indirect

prescribing for elderly patients at

ophthalmoscopy, 301–308

risk, 146–147

with indirect biomicroscopy,

recording history of falls, 25

286–294

false negatives, visual field

by monocular indirect

assessment, 63

ophthalmoscopy, 299–306

false positives, visual field

with pupillary dilation, 8

assessment, 6–8, 63

relevance for considering physical

family medical history, 21–22, 25

examination procedures, 320

information for considering

scleral indentation with headband

physical examination

BIO, 306–308

procedures, 319–340

fundus biomicroscopy, 12, 41–42

information for visual function

indirect, 286–294

assessment, 29

see also website

family ocular history (FOH), 21–24

fundus pigmentation

information for determination of

in normal elderly eye, 235

the refractive correction, 84

in normal eye in young adults,

information for ocular health

226–228 (Figs 6.10-6.15),

assessment, 222

227–228 see also website

fan and block test, for astigmatism,

fusion assessment with Worth 4-dot

114 (Fig. 4.11), 117–119

test, 197–199

Farnsworth–Munsell D-15 test,

fusional reserves measurement,

69–72, 69 (Fig. 3.10)

180–184

fast central visual field analysis, 53–57

20 base-out test, 183–184

FDP (frequency doubling perimetry),

fusional vergence facility

50–53

measurement, 187–188

filters for slit-lamp biomicroscopes,

237 (Tbl. 6.1)

GAT see Goldmann Applanation

fixation disparity, 12

Tonometry

Mallett unit, 184–187, 184

Gaze Tracking plots, visual field

(Figs 5.8–5.9)

assessment, 43, 55, 63

measurement device, 114 (Fig. 4.11)

glare testing, 47, 48, 222

fixation losses, visual field

glaucoma

assessment, 63

angle measurement as precaution

fixation sticks, 159 (Fig. 5.1)

against inducing, 262–263

flare, aqueous, 247

as cause of acquired colour

recording, 248

defects, 69

flashes, 221, 234–235

closed-angle, 222

floaters see vitreous floaters

family history of, 22

fluorescein dye, 246, 249, 250, 273

FDP testing for early glaucoma, 51

dye disappearance test, 256, 257,

following LASIK, 273

259, 260

as indication for gonioscopy, 264

staining patterns, 251 (Fig. 6.46)

NRR thinning with, 293

see also website

POAG (primary open-angle

focimeters, 90–92, 96, 97

glaucoma), 6–7, 8, 221,

foveal suppression, 200

222, 264

lamina cribosa, 226, 226 (Fig. 6.9), 227

in normal eye in young adults, 225

Monet, Claude, 70

(Fig. 6.13)

(Fig. 6.7), 227 see also website

monocular accommodation values,

see also website

maculopathy, 20, 43, 44, 70, 104, 221

193

Lang stereotest, 206

progression of macular

monocular examiners

LASIK refractive surgery, 2

pigmentary changes to, 235

indirect ophthalmoscopy by, 299

lacrimal occlusion following,

Maddox rod test, 171–174

retinoscopy method for, 101

253, 255

9-point test, 212–214

monocular fogging balance, 121–123,

late detection of glaucoma

double rod test, 214

125–126

following, 273

Maddox wing measurement,

monocular indirect ophthalmoscopy,

latent deviation see heterophoria

174–176

299–301

latent hyperopia, 122, 128, 131

malingerers, 44, 74, 98, 103

monocular subjective refraction,

prescribing for latent hyperopes, 144

Mallett fixation disparity unit,

104–107, 120–121, 122

latent nystagmus, 54, 58, 62, 105, 125

184–187, 184 (Figs 5.8–5.9), 197 motility test (broad H test), 207–211

Lea symbols, visual acuity, 36

management plans

pursuits test, 211–212

lens appearance, crystalline see

giving plans to patients, 19

MPMVA (maximum plus to

crystalline lens appearance

problem–plan list, 311–312

maximum visual acuity)

lens optical section illumination

Matrix perimeter, 50, 51, 53, 61

technique, 107–108, 121

technique, 242–243, 243

maximum plus to maximum visual

multifocal lens spectacles

(Fig. 6.39)

acuity (MPMVA) technique,

falling risks with, 147

see also website

107–108, 121

lens identification, 92, 93

lensometers see focimeters

media opacities, 102

multiple sclerosis, 49, 222

letters of referral, 312–314

see also cataracts

multiple stimulus suprathreshold

limbal girdle of Vogt, 232, 232

medical history, 21

strategy, 57–59

(Fig. 6.22)

information for binocular vision

myasthenia gravis, 216

see also website

assessment, 152, 153

mydriatics, 279, 280, 281, 283

Lissamine green staining, 250–251

information for considering

myelinated nerve fibres, 227, 227

listening skills, 18

physical examination

(Fig. 6.12)

Llandolt C chart, visual acuity, 36

procedures, 319–340

see also website

LOFTSEA acronym, case history, 22–23

information for determination of

myopia/myopes

logMAR notation, visual acuity, 39

the refractive correction, 84

amount of visual acuity loss,

logMAR visual acuity (VA) charts,

information for visual function

33–34, 37, 83–84

29–34, 84–85

assessment, 29

appearance of the myopic eye, 226

low contrast charts, 50

medication information, 21, 24–25

(Figs 6.9, 6.11), 227 (Fig. 6.13),

lymph node palpation, 320–322

Medmont M-700 perimeter, 53, 61, 65

229–230 see also website

see also website

meibomian gland evaluation, 247

calculating refractive corrections

melanoma, 224

for, 85

M-scale notation, 39

benign choroidal, 228, 228 (Fig. 6.14)

family history of, 22, 84

macular assessment

see also website

juvenile onset, 84

10-2 central visual field analysis, 43

malignant, 228, 306

keratometry interpretation and, 89

with Amsler Grid, 44–45

melanosis, 223

prescribing for non-progressive

direct ophthalmoscopy

see also website

myopes, 144

examination, 298

MEM (Monocular Estimation

progression, 84

with Goldmann 3-mirror

Method) dynamic

symptoms of myopia, 84

(universal) lens, 308–310

retinoscopy, 194–195

myopic crescents, 226 (Fig. 6.9), 230

indirect fundus biomicroscopy

Ménière’s disease, 25, 147

examination, 293

microtropia, 199–201

N notation near card test, 38–41

macular degeneration

migraine, 29, 61, 146

naevi, 223–224, 235

age-related (ARMD), 41, 48

Mittendorf dot, 224, 224 (Fig. 6.4)

choroidal naevus, 228, 293 (Fig.

exudative, 41

see also website

6.69) see also website

macular function, in photostress

modified gradient AC/A ratio test,

nasolacrimal stenosis and blockage

recovery time, 46

178–180

(epiphora), 22, 230, 249, 255,

macular oedema, 45, 47, 295

modified Humphriss (monocular

256–260

VA readings with, 41

fogging balance), 121–123, 125

NCT (non-contact tonometry), 5,

macular pigmentation

modified Thorington test, 169–171

276–279

in normal elderly eye, 235, 235

9-point test, 212–214

near point of convergence (NPC)

(Fig. 6.31) see also website

Mohindra near retinoscopy, 131–132

test, 188–190

near visual acuity, 38–41

gonioscopy with Goldmann

Oculus programs, 43

near visual adequacy testing, 38–41

3-mirror lens, 264–269

ophthalmodynamometry, 327

see also reading addition

headband binocular indirect

ophthalmoplegia, internuclear, 216

nerve fibre layer examination,

ophthalmoscopy (BIO),

ophthalmoscopy, binocular indirect

290–291, 292

301–308

(BIO)

nerve fibre layer striations, 225–226,

indirect fundus biomicroscopy,

in dilated fundus examination, 8

225–226 (Figs 6.6-6.10), 291

286–294

headband, 301–308

see also website

information for considering

ophthalmoscopy, direct, 294–299

neural retinal rim (NRR), 291, 292,

physical examination

in dilated fundus examination, 8

293, 297

procedures, 320

ophthalmoscopy, headband

‘neutral point’, retinoscopy, 99, 100

information from other

binocular indirect, 301–306

see also website

assessments for, 222

scleral indentation with, 306–308

NIBUT (non-invasive break-up

Jones 1 and 2 and associated tests,

ophthalmoscopy, monocular indirect,

time), 250

256–260

299–301

non-compliance, 19

monocular indirect

opsin, 46

non-contact tonometry (NCT), 5,

ophthalmoscopy, 299–301

optic cupping, 225–226, 225–226

276–279

non-contact tonometry (NCT),

(Figs 6.6-6.10), 291–292

Nott Dynamic retinoscopy, 194–195

276–279

see also website

NPC (near point of convergence)

Perkins tonometry, 275–276

optic nerve head appearance

test, 188–190

phenol red thread and Schirmer

ISNT rule, 293

NRR (neural retinal rim), 291, 292,

tests, 251–253

with myopia, 230

293, 297

problem–plan list, 311–312

in normal eye in young adults,

nuclear cataracts, 84, 233, 233

pupil light reflexes and swinging

225–227, 225–227 (Figs

(Fig. 6.26), 242, 298

flashlight test, 283–286

6.6–6.13) see also website

see also website

referrals and reports, 312–314

optic nerve head examination, 289,

nystagmus, 104, 161, 208, 216

scleral indentation with headband

291–292, 293

latent nystagmus, 54, 58, 62, 105, 125

BIO assessment, 306–308

optic neuritis, 48, 49

shadow test angle estimation,

optometry, patient-centred, 14

objective measurement of

262–263

orthokeratology, 85

heterotropia, 167–169

slit-lamp biomicroscopy

orthophoria, 154

objective measurement of refractive

examination, 236–248

error, 97–98, 103

tear break-up time, 249–251

palisades of Vogt, 223

autorefraction, 103–104

van Herick angle assessment,

see also website

retinoscopy, 97–103 see also website

260–262

PanOptic, Welch Allyn, 299, 300–301

Octopus perimeter, 43, 53, 59, 61,

variations in appearance of

Panum’s areas, 184

64, 65

the normal elderly eye,

papilloedema, 294

ocular disease

230–236

papilloma, 230, 232 (Fig. 6.24)

giving bad news of, 20

variations in appearance of the

see also website

hereditary diseases, 222

normal eye in young adults,

Parinaud oculoglandular

providing instructions on

222–230

conjunctivitis, 319, 322

managing, 19

ocular history (OH), 21, 23–24

Parkinson’s disease, 216

symptoms of, 29, 221

information for binocular vision

Park’s 3-step test, 214–215

ocular health assessment

assessment, 152, 153

Pascal tonometer, 273

case history information for,

information for determination

patient anxiety, 17–18

221–222

of the refractive correction,

patient-centred optometry, 14

diagnostic drug instillation, 279–283

83–84

patient information

diagnostic lacrimal occlusion,

information for ocular health

collecting information from

253–256

assessment, 221–222

patients see case history

digital imaging, 310–311

information for visual function

giving information to patients see

direct ophthalmoscopy, 8, 294–299

assessment, 29

information for patients

Goldmann 3-mirror universal

ocular motor nerve paresis, 216

patient satisfaction

examination, 264–269, 308–310

ocular motor palsy, 206–207

complaints about incorrect reading

Goldmann Applanation

see also incomitant heterotropia

addition, 139

Tonometry (GAT), 272–276

oculovisual systems, 12

as a gold standard, 2, 3

gonioscopy with corneal-type

Oculus perimeters, 53, 59–60, 61,

importance of, 14

lenses, 269–272

64, 65

patient vocation, 22, 25

rapport with patient, 6, 13

plus/minus best vision sphere

in normal elderly eye, 235–236, 235

relaxation and, 18

assessment, 108–111

(Fig. 6.31–6.32) see also website

reading addition

prism-dissociated blur balance of

in normal eye in young adults,

tentative reading addition

accommodation, 119–121

228–229, 229 (Fig. 6.16) see also

using assessments of

simple axis rotation, 118–119

website

accommodation, 137–139

static retinoscopy, 97–103

retinal detachment, 8, 23

tentative reading addition using

tentative reading addition using

retinal pigment epithelium see RPE

calculations, 132–137

assessments of

retinal tears, 235

test comparisons for, 2–3

accommodation, 137–139

retinopathy

trial frame determination of

tentative reading addition using

diabetic, 24, 69, 264, 320, 327

reading addition and range of

calculations, 132–137

hypertensive, 235, 323, 325

clear vision, 139–143

trial frame determination of

venous stasis, 327

reassurance, 18, 19, 147–148

reading addition and range of

retinoscopy

receiver operating characteristic

clear vision, 139–143

with cycloplegic refraction, 130–132

(ROC) curves, 4

Turville Infinity Balance (TIB),

information relevant for

record-keeping, 14, 25

124–125

assessment of binocular

for individual tests see individual

refractive error prescriptions,

vision, 153

tests

143–147

Mohindra near retinoscopy, 131–132

of poor adaptation to spectacles,

refractive surgery, 2, 47, 48, 50, 85,

Nott and Mem Dynamic

145

273

retinoscopy, 194–195

record cards, 14, 15–16 (Fig. 2.1)

lacrimal occlusion following

reflexes see reflexes, retinoscopy

recording the case history, 26–27

LASIK, 253, 255

refractive error determination see

redness of the eye, 221, 249, 319, 320

Reichart non-contact tonometry,

refractive error determination

referral letters, 312–314

277–278

spot, 98, 101

reflexes, retinoscopy

relationship with patient

static, 97–103

‘against’ movement, 99–100 see also

communication skills for see

streak, 98–101

website

communication skills

wet and dry, 130–131

dim reflex, 101–102

counselling the patient, 147–148

retro-illumination

‘scissors’ reflex, 102

demonstrating changes to the

from the fundus, 244, 244 (Figs

‘with’ movement, 99–100 see also

patient, 143

6.41–6.42) see also website

website

explaining diagnoses, prognoses

from the iris, 243–244

refractive error determination

and management plans, 19,

rhodopsin, 46

autorefraction, 2, 103–104

147–148, 311

Risley prisms, 95–96, 120, 180

binocular subjective refraction,

rapport, 6, 13, 18

Rose Bengal staining, 250–251

125–128

relative afferent pupillary defect

rotary prisms see Risley prisms

case history information for, 83–84

(RAPD), 284, 285

routine screening, 5–8

clock dial test, 117, 119

relaxing the patient, 18

RPE (retinal pigment epithelium)

counselling the patient after,

reliability indices, visual field

fundus pigmentation and, 226–228

147–148

assessment, 43, 52, 55, 59, 61,

(Figs 6.10-6.15), 227, 235 see

cycloplegic refraction, 12, 102,

63

also website

128–132

reliability of tests, 4–5

hyperplasia, 229, 236

duochrome/bichrome test, 111–112

see also validity assessment

loss with peripapillary atrophy, 227

fan and block test, 114 (Fig. 4.11),

repeatability of PD measurements, 95

soft drusen and, 235

117–119

repeatability of tests, 4–5

window defects, 228 see also website

Humphriss Immediate Contrast

repetition of tests, 65

(HIC), 123–124

of NCT readings, 278

saccadic movement assessment,

Jackson cross-cylinder test, 112–117

to overcome false positives, 7–8

215–217

see also examples on website

reports, 312–314

Sampaolesi’s line, 266 (Fig. 6.55), 268

Mohindra near retinoscopy, 131–132

research literature, 1–5

Schirmer tear test, 251–253

monocular fogging balance,

on routine screening, 5–8

Schlemm’s canal, 268, 269

121–123

Retinal Acuity Meter, 42

Schwalbe’s line, 266 (Fig. 6.55),

monocular subjective refraction,

retinal blood vessel appearance

267, 268

104–107, 120–121, 122

indirect fundus biomicroscopy

‘scissors’ reflex, 102

MPMVA best vision sphere

recording of, 292

scleral indentation, 306–308

assessment, 107–108, 121

with myopia, 226 (Fig. 6.11), 230

scleral spur (SS), 269

sclerotic scatter illumination

specificity, 4, 6–7

technique, 241–242, 241

spectacle costs, 17, 148

(Fig. 6.37)

spectacle lens identification, 90–93

see also website

specular reflection, slit-lamp

screening

biomicroscopy, 244–246, 245

central field see central visual field

(Fig. 6.43)

screening

see also website

FDP screening, 50–53

sphygmomanometry, 319–320,

gross visual field, 68

322–326

multiple stimulus suprathreshold

spot retinoscopy, 98, 101

screening, 57–59

SPP-2 (Standard Pseudoisochromatic

peripheral field, 65–66

Plates Part 2), 78–79

routine screening, 5–8

squint see strabismus

suprathreshold screening, 57–60,

static retinoscopy, 97–103

65–66

stereopsis testing

sebaceous cysts, 230, 231 (Fig. 6.18)

Frisby test, 201, 203–204, 204

see also website

(Fig. 5.14)

Seidel’s test, 246

Lang stereotest, 206

sensitivity, 4, 6–7

Titmus Fly test, 204–206, 205

shadow test angle estimation, 262–263

(Fig. 5.15)

Shaefer system, 268

TNO stereo test, 201–204, 202

Shafer’s sign, 235

(Fig. 5.13)

Sheard’s rule, 183

use of clinical assistants for

Sheard’s technique, 192

screening, 5–6

Sheridan-Gardner chart, visual

strabismus

acuity, 36

advantage of trial frame with, 97

short sightedness see

Bruckner test for strabismus in

myopia/myopes

infants, 168–169 see also website

simple axis rotation, 118–119

comitant heterotropia

simple penlight glare test, 47–48

classification, 155–157

single field analysis, 43, 55, 56

cover test and, 2, 157–167 see also

(Fig. 3.6), 63–64

website

single point suprathreshold

family history of, 22

screening, 59–60

microtropia and, 200

SITAFast, 53–57, 61

retinoscopy in patients with, 102

SITAStandard, 43, 55, 56, 61–63

stereoacuity and, 201, 203

Sjögren’s syndrome, 251, 252

see also heterotropia

slit-lamp biomicroscopy examination

streak retinoscopy, 98–101

of the anterior segment and ocular

subjective refraction, 2

adnexa, 236–241 see also

binocular, 125–128

website

hyperopia and, 122

checks prior to mydriatic

information relevant for

instillation, 280

assessment of binocular

with fluorescein, 246

vision, 153

relevance for considering physical

monocular, 104–107, 120–121, 122

examination procedures, 320

submandibular lymph node

specialised illumination

palpation, 321–322

techniques, 241–248

see also website

small letter contrast sensitivity, 50

submandibular lymphadenopathy,

smoking, 249, 319, 320, 324, 325, 327

322

Snellen charts, visual acuity, 34–38,

submental lymph node palpation,

114 (Fig. 4.11)

321–322

Snellen notation, 32, 33, 34–35

see also website

SOAP (Subjective, Objective,

super pinhole visual acuity test,

Assessment, Plan) acronym, 14

41–43